Heilkunst: Medicine Grounded in Lived Experience

Samuel Hahnemann, the founder of Heilkunst homeopathy, recognized the need to ground medicine in lived experience. He was critical of the attempt in clinical pathology to locate the source of disease in disease tissue and argued for the importance of understanding disease dynamically.

Hahnemann found the reduction of a disease to its final manifestation in autopsy to be a shoddy basis of medicine. “What nosologist” he asked rhetorically, “ever saw with bodily eyes such a disease-matter, that he could so confidently speak of it and want to build a medical system upon it?” [1]. His criticisms were ultimately informed by the conviction that everything that is remediable in disease makes itself known to the physician by diseased symptoms. In section fourteen of the Organon, he writes: “There is nothing remediably diseased nor any remediable invisible disease alteration in the human interior, that would not present itself for discernment to the exactly observing physician by disease signs and symptoms” [2]. This conviction, in turn, is based on the conviction that the remedial artist can derive no benefit from probing into how and why an organism becomes diseased – – “that will remain eternally hidden from him” – – and the corresponding assurance that his senses are “necessary and fully sufficient for him to be aware of [the disease] for remedial purposes” [3].

Hahnemann’s position stands in stark contrast with the one guiding clinical pathology, which “accepts as real the possibility that inner and outer could have no connection whatsoever. . . that symptoms might tell nothing of disease” [4]. From this assumption “the project of knowing bodies is conceived as the problem of making certain inner and outer are not apart. These approaches to knowing the patient and his body produce dualistic images of the body and sentience” [5]. When medicine seeks to know the material cause of a person’s disease independent of his cooperation, its success lies in effectively distinguishing between the experience of the disease and the disease itself. In short, the problem is that when clinical inquiry strives toward the certainty gained at autopsy, the pursuit of medical truth increasingly relies on bypassing the patient’s capacity for self-interpretation. It overrides the patient’s lived experience.

In Heilkunst, self-interpretation provides the basis of medicine. Diagnosing diseases involves an experience-based recognition of the similarity between an illness and a remedy. The capacity for self-interpretation is paramount for practitioners and patients alike. In stark contrast with diagnostic methods that progressively reduce patient involvement in anticipation of his total elimination at autopsy, Heilkunst anticipates and ever approximates health.